7 research outputs found
Causes of death in patients with unipolar single chamber ventricular pacing: prevalence and circumstances in dependence on arrhythmias leading to pacemaker implantation.
analysis of different causes of death in patinets with pacemake
Gastrointestinal perforation: ultrasonographic diagnosis
Gastrointestinal tract perforations can occur for various causes such as peptic ulcer, inflammatory disease, blunt or
penetrating trauma, iatrogenic factors, foreign body or a neoplasm that require an early recognition and, often, a
surgical treatment.
Ultrasonography could be useful as an initial diagnostic test to determine, in various cases the presence and,
sometimes, the cause of the pneumoperitoneum.
The main sonographic sign of perforation is free intraperitoneal air, resulting in an increased echogenicity of a
peritoneal stripe associated with multiple reflection artifacts and characteristic comet-tail appearance.
It is best detected using linear probes in the right upper quadrant between the anterior abdominal wall, in the
prehepatic space.
Direct sign of perforation may be detectable, particularly if they are associated with other sonographic
abnormalities, called indirect signs, like thickened bowel loop and air bubbles in ascitic fluid or in a localized fluid
collection, bowel or gallbladder thickened wall associated with decreased bowel motility or ileus.
Neverthless, this exam has its own pitfalls. It is strongly operator-dependant; some machines have low-quality
images that may not able to detect intraperitoneal free air; furthermore, some patients may be less cooperative to
allow for scanning of different regions; sonography is also difficult in obese patients and with those having
subcutaneous emphysema. Although CT has more accuracy in the detection of the site of perforation, ultrasound
may be particularly useful also in patient groups where radiation burden should be limited notably children and
pregnant women